Provider Demographics
NPI:1245275890
Name:LEDA SANCHEZ MD SC
Entity type:Organization
Organization Name:LEDA SANCHEZ MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEDA
Authorized Official - Middle Name:ARELY
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-946-1828
Mailing Address - Street 1:360 E RANDOLPH ST
Mailing Address - Street 2:SUITE 3907
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7340
Mailing Address - Country:US
Mailing Address - Phone:312-946-1828
Mailing Address - Fax:773-907-3531
Practice Address - Street 1:5140 NORTH CALIFORNIA AVENUE
Practice Address - Street 2:SUITE 620
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3664
Practice Address - Country:US
Practice Address - Phone:312-952-9692
Practice Address - Fax:773-907-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360759012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C43241Medicare UPIN